Nicole D Qualls, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008467 Issued in NC

Practice address

104 N Main St
Louisburg, NC 27549-2516

Phone

(919) 496-7781

NPI assigned

Jan 24, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1528306685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 CEDAR RIDGE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909899",
            "telephone_number": "252-702-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492516",
            "telephone_number": "919-496-7781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925D Conference Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278585971",
            "country_code": "US",
            "telephone_number": "252-752-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinewood Manor of NC Inc
• Melody A Poli
• Precision Radiation Oncology Systems
• Carla Primo, SOCIAL WORKER
• Privettes Resources LLC
• Gabrielle Quinones
• Jane B Quintana, D.D.S
• Shanika Ro'Sha Ragland, LPC, LCAS-A
• Rehoboth Group, LLC
• Relief Integrated Healthcare

• Clinical Social Worker in Louisburg, NC
• Providers in Louisburg, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.